Every year the Phoenix Magazine publishes a guide featuring over 300 of the Valley's best physicians. The doctors are selected through a peer-review survey. The theory is that medical professionals are the best qualified to judge medical professionals. The survey asks the doctors to nominate those doctors who, in their judgment, are the best in their fields.

Once again, Dr. Lakin has been chosen as a TOP DOC among his peers.

Please join us in congratulating Dr. Lakin again!

You might put sugar in coffee, spoon it on cereal and sprinkle it on fruit. It's even hidden in many packaged foods, such as spaghetti sauce and soups. But for optimal health, it's best to limit your sugar intake, says nutritionist and cookbook author Robyn Webb. If you have a serious sweet tooth, consider these alternatives:

Raw honey contains vitamins and minerals. There are 300-plus varieties in this country, offering an array of flavors. Webb suggests using a little in oatmeal, marinades and salad dressings.

Agave nectar is derived from a desert plant. Swap it for sugar when making baked goods. It's a liquid sweetener, so you'll need to reduce any other liquids in your recipes.

Stevia is sold in U.S. supermarkets as a dietary supplement or in tiny packets as a blend. Webb recommends it for diabetics who want to sweeten drinks. "More research needs to be done, but it doesn't appear to affect blood sugar levels like other sugars do," she says.

Fuel up wisely.

 

Accentuate the positive when it comes to food. "Diet" implies a rigorous, self-sacrificial discipline that's doomed to fail. Instead, focus on achieving food goals of what you should eat each day rather than what you shouldn't eat. When you consume more fruits, vegetables, healthy fats (such as olive oil and nuts) and lean proteins, your hunger will be satisfied and you'll naturally want to make better choices.

Stay fit.

As we age, our heart, lungs and other internal organs change. Our capacity to exert ourselves is reduced, and our tolerance to heat, cold and humidity changes. Our muscle strength and density diminish. Our joints wear down. Our bones lose density. But this doesn't mean we can't exercise. We just need to exercise smarter. Do low-impact workouts, such as walking, and strength-train to maintain muscle tone, metabolism and bone density. Include flexibility and balance exercises, via activities like yoga, to aid your ability to function fully as you age.

Bolster brain health.

Part of successful aging includes maintaining neurological health. Although certain degenerative brain illnesses can strike anyone, keeping healthy habits offers some protection. Exercising regularly and eating a healthful diet helps the brain as much as the rest of the body. Reading, doing crossword or Sudoku puzzles and learning a new skill (music, languages) all are beneficial because they require the brain cells to "fire."

Adjust your outlook.

Maintain a positive attitude, which is necessary for successful aging. It gives us the resolve to implement changes that'll be beneficial.

The student naval aviator was flying in formation - a high pressure maneuver anytime, but especially when you're still trying to make the grade - when he suddenly started laughing. Hysterically laughing. Laughing so hard he endangered the flight.

This wasn't the first time the man had broken out in uncontrollable laughter at a seemingly strange moment. In fact, the young pilot had been waking up other members of his household in the middle of night as he, sound asleep, broke out in peals of laughter.

As it turned out, the pilot, who showed no other symptoms when he was documented with the problem in 1997, was experiencing a rare form of epileptic episode called gelastic seizure. The main symptom of a gelastic seizure is uncontrolled laughter.

Laughing or crying at inappropriate moments, or out of context to one's circumstances - crying in the middle of a lecture, for example, or laughing at a funeral - is something most of us experience at least once.

However, as the case of the pilot illustrates, there can be a variety of underlying causes for these ill-timed outbursts. Multiple sclerosis, ALS (Lou Gehrig's disease), stroke, Alzheimer's disease, Parkinson's disease or any number of conditions can cause brain lesions or damage the communications between different parts of the brain. The result is pathological laughing or crying, also sometimes called involuntary emotional expression disorder. Now, Cleveland Clinic researchers are testing an experimental treatment, a combination of two medications, dextromethorphan and low-dose quinidine, to help control the involuntary outbursts.

However, involuntary emotional expression disorder turns out to be something of a misnomer. In fact, true laughter and most crying are never voluntary, according to Robert Provine, author of "Laughter: A Scientific Investigation," and a professor of psychologyand assistant director of the neuroscience program at the University of Maryland, Baltimore County

"All laughter is unconscious," he said. "You do not chose to laugh the way you chose to speak."

In the book, Provine relates an amazing tale of an incident that took place in 1962, in Tanganyika (now Tanzania). A group of schoolgirls began laughing. Other girls saw and heard their laughter and they started laughing. Soon, the entire school was giggling uncontrollably, so much so that school had to be dismissed. This epidemic of uncontrollable, contagious laughter went on for six months.
 
When someone with a brain lesion or neuron damage suffers fits of laughter or crying without feeling especially happy or sad, a skilled neurologist can point to a cause. Explaining why an otherwise healthy person might break into tears or start laughing is more difficult.

Dr. Josef Parvizi, a Stanford University neurologist who studies seizures and pathological crying and laughing, agrees that outbursts of laughter or crying are not really under our complete control, no matter how much we think they are.

Our brains are a dynamic set of interconnected structures with wiring forming a system that has evolved over millions of years, Parvizi said. The idea that human beings can exert complete control over this system the way we can program a computer is a relic of old-fashioned hubris and moralizing.

Crying and laughter depend on flexible interplay between these brain structures, some of which are evolutionarily ancient. That interplay often takes place without our conscious selves knowing anything about it, just as our brain tells our hearts to beat. So, just as something like a nerve communication foul-up can create a harmless momentary heart flutter, the brain regions involved in laughing or crying could evoke a sudden outburst.

Just as nerve communications cause our hearts to beat without us being aware of it, the sight of someone falling down the stairs can evoke a loud guffaw before we can stop it.

Neuroscientists have found that they can evoke crying jags by stimulating a structure called the subthalamic nucleus. When scientists used electrodes to stimulate a region called the anterior cingulate, they got smiles. By turning up the juice, they triggered long, hearty laughter. Yet the patient did not "feel" especially funny.

Most laughter is not the result of a joke, Provine said. It's a form of social communication which is embedded in our brains. When chimps wrestle, they laugh. When mice are tickled, they laugh.

In reality, humor is a mystery, at least in the way it affects the brain. While it's acceptable to laugh at slapstick and jokes, it's not OK to laugh at funerals. One is socially acceptable; the other isn't. Yet both can trigger laughter and we're powerless to stop it.

This is not to say that our cortex, the reasoning part of our brains, cannot exert some control over an urge to cry or laugh. But although we tend to regard human beings as having free will, what we really have is some limited ability to deny or to act upon our brain's desires.

"What the brain will want to do is not free," Parvizi said. "The fact I want ice cream at this moment is out of my control." He may or may not help himself to ice cream, but he can't prevent his brain from wanting it.

Our conscious brain tries to control these desires according to the norms of our culture as we learn through experience what our emotional response ought to be to various situations.

"The circuitry that controls emotional expression first processes what is outside, the situation," he said. "Then it relates this particular situation to past experiences and how the brain has learned to respond. Then it triggers the emotional response. It's all to some extent involuntary and spontaneous." Nobody knows exactly why this system might malfunction in the absence of a disease or injury.

But clearly something has gone momentarily haywire.

When such an inappropriate response is triggered, like when we are listening to great aunt Judy's eulogy, Parvizi said about the best we can do is chalk it up to a "glitch" and hope the relatives don't boot us out of the will.

                                                     - By Brian Alexander, contributor

Go on, give it a try. We think you'll enjoy it!

Start your unplugged weekend.

Before Friday, explain that each family member must suggest a game or an activity for your unplugged weekend. It doesn't have to be new or elaborate, just something that involves everyone. Tell spooky stories, take a hike in a nature reserve, go ice-skating or play a card game. Not only will your kids have fun, but we also bet these good old-fashioned activities will become family favorites.

Enjoy a fun, easy breakfast.

Kick off the weekend with a special family breakfast on Saturday morning. Set up a sundae bar: Fill parfait glasses with fresh fruit, such as berries or peach slices, as well as a few spoonfuls of yogurt and a sprinkle of granola. Top each healthful treat with a cherry and eat with a long-handled spoon.

Go on a tiny treasure hunt hike.

To keep everyone moving along the trail on a nature walk, play a fun game. Give each family member a matching small container, such as a mint tin or a zippered plastic bag, and challenge everyone to fill it with items from the great outdoors in a certain amount of time. Offer prizes for the person who gets the most objects, the widest variety of items or the most things in one color.

Liven up dinner conversation.

Take some small pieces of paper and write questions on them, such as, "If you could have a superpower, which one would you want?" "What does it mean to be a best friend?" "What's your favorite movie?" Then, fill a large, empty jar with the questions. Each family member takes a turn picking a question to answer while the rest of the family listens, learns and laughs.

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